Pumpkin Lasagna Recipe with Spinach and Meatza

This content originally appeared on Low Carb Yum. Republished with permission.

The first thing that comes to mind when you talk about pumpkin as food is usually pumpkin pie or some other sweet dish. However, I came across a recipe for pumpkin lasagna a couple of weeks ago that I really wanted to try.

Low-carb lasagna noodles are available, but I have started to get away from using wheat products as I believe there are many benefits to eating gluten-free. Therefore, I decided to try a “meatza” layer in the lasagna in place of the noodles where I used the meat part of the Spinach Tomato Meatza Pizza Recipe.

I made a few other changes to the original recipe to suit my taste and lower the carbs. Since there aren’t any actual lasagna noodles in this dish, some may argue that it’s really a casserole versus true lasagna.

However, it looks and tastes like lasagna using a pumpkin sauce rather than the traditional tomato-based sauce. Therefore, I have kept the title of this recipe as a lasagna rather than a casserole.

Pumpkin Lasagna

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Pumpkin Lasagna with Spinach

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A low carb lasagna featuring pumpkin, spinach, and meatza noodles. The pasta noodles in this dish have been replaced with pre-baked seasoned ground beef.
Course Main Course
Cuisine American, Italian
Keyword fall, lasagna, pumpkin
Prep Time 15 minutes
Cook Time 40 minutes
Total Time 55 minutes
Servings 12 squares
Calories 401kcal

Ingredients

Meatza ingredients:

  • 2 eggs
  • 1/2 cup parmesan cheese grated
  • 2 teaspoons Italian seasonings
  • 1 teaspoon garlic powder
  • 1 teaspoon salt
  • 2 pounds ground beef

Lasagna ingredients:

  • 1-2 tablespoon olive oil
  • 6 cups fresh baby spinach
  • 15 ounces canned pumpkin puree
  • 1 1/2 cups almond milk or half almond milk half heavy cream
  • 2 teaspoons dried rubbed sage
  • 1 teaspoon salt
  • 1/2 teaspoon ground black pepper
  • dash ground nutmeg
  • 15 ounces whole milk Ricotta cheese
  • 2 cups mozzarella cheese shredded
  • 1 cup parmesan cheese shredded or grated
  • Prepared Meatza

Instructions

Prepare the meatza:

  • Beat the eggs with the parmesan cheese and all seasonings. Add the ground beef and mix until well combined.
  • Spread mixture out onto a jelly roll pan. Bake for about 15-20 minutes in a 450°F oven.
  • Drain off any grease after removing from the oven. Slice into rectangular pieces to fit into lasagna pan.

Lasagna directions:

  • Heat olive oil in a large pot over medium high heat. Add spinach and stir until spinach is wilted. Remove from heat.
  • Combine pumpkin, almond milk, sage, salt, pepper and nutmeg in bowl.
  • Spread 1/2 cup pumpkin sauce onto bottom of 9×13 baking pan. Top with half of the cut up meatza.
  • Spread 1/2 of the remaining pumpkin sauce on top of the meatza layer then cover with spinach. Top with half of the ricotta, half of the mozzarella, and half of the parmesan cheeses. Repeat layers. Cover with foil.
  • Bake at 375 °F for 30 minutes.
  • Remove foil and bake uncovered for an additional 10 minutes or until cheese is melted and browned.

Notes

Baking the meat into thin meatloaf pieces is what holds the lasagna together. The meat should be pressed into a rimmed baking sheet to be as thin as possible.

To prevent over-browning the cheese, cover the casserole pan with foil while baking. Then remove the foil during the last ten minutes of baking to brown the cheese.

Nutrition

Calories: 401kcal | Carbohydrates: 5g | Protein: 27g | Fat: 29g | Saturated Fat: 13g | Cholesterol: 122mg | Sodium: 850mg | Potassium: 441mg | Fiber: 1g | Vitamin A: 7350IU | Vitamin C: 5.7mg | Calcium: 400mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Pumpkin Lasagna With Spinach and Meatza Recipe

Source: diabetesdaily.com

What I Wish People Knew About Type 3C Diabetes

This content originally appeared on Beyond Type 1. Republished with permission.

By Jen M.

What do you think of when you think of a diabetes diagnosis story? It could be a type 1 diagnosis story when someone experiences diabetic ketoacidosis (DKA) symptoms and gets admitted to the hospital. It could be a type 2 diagnosis story of someone diagnosed through blood work at a routine doctor’s appointment. My story is a little bit different.

I am a type 3c diabetic. Most people I converse with have never heard of my type, and that’s okay. Since my diagnosis, I have found a passion for educating the general public and the diabetes community about type 3c and what life is like living without a pancreas.

You read that right, I don’t have a pancreas at all!

In December 2015, I woke up with severe abdominal pain. At first I thought it may have been a stomach ache and tried to rest. As the day went on, the pain continued to get more severe. And when I say severe, I mean the worst pain I have ever felt. It is difficult to even put the experience into words. I was visiting my parents for Christmas and my mom drove me to the local emergency room. What I thought would be a quick trip turned into a 4 week stay. I was diagnosed with pancreatitis and they spent those weeks trying to get the pain under control and figure out why this was happening.

The journey to figure out why I, a 25 year old with no family history and no alcohol use, was having repeated episodes of pancreatitis took about 7 months. I was in and out of the hospital every few weeks with recurring flares. I’ll spare all of the details, but it was finally determined that I had two genetic mutations in the SPINK gene and the CFTR gene. The combination of these gene mutations explained why I had chronic pancreatitis. I consulted with several doctors at different hospitals and they all agreed that the best plan of action to improve my quality of life would be to perform a total pancreatectomy.

I had my surgery on February 2, 2017, a little over 1 year after my first diagnosed pancreatitis flare. The surgery is called a total pancreatectomy with autologous islet cell transplant (TPAIT). The surgeon removed my pancreas, spleen, gall bladder, duodenum, and lower portion of my stomach. As people with diabetes know, insulin is incredibly important, so in an ideal case, the surgeon would remove the pancreas and isolate the islet cells from the pancreas and transplant them into my liver. According to my surgeon, 36.9% of patients in his research studies became independent from insulin after islet transplant. Hearing this before surgery made me optimistic, however there was extensive damage and calcification to my pancreas when they removed it and the islet cell yield made my transplant unsuccessful. I have been fully insulin-dependent since the second my pancreas was removed from my body.

So I want to explain briefly exactly what type 3c diabetes is. It is referred to as “pancreatogenic” diabetes, which means diabetes that results from a pancreatic condition. Examples of pancreatic conditions could be exocrine insufficiency, pancreatitis, cystic fibrosis, pancreatic cancer, or partial or total pancreatectomy. As you can imagine, it is a complex condition that is not widely researched or even recognized by many medical professionals. After asking my close TPAIT friends, most of us don’t even have the diagnosis of type 3c in our charts, because insurance won’t cover devices and supplies under that diagnosis code. Most of us have type 1 diabetes as our chart diagnosis, an entirely different autoimmune condition.

Type 3c may have similarities to type 1 due to the fact that both conditions require insulin, but that’s the only similarity. There are a few big differences to note. With TPAIT related type 3c specifically, since our pancreases are completely removed we have no alpha cells. In the most simplified definition, alpha cells secrete glucagon, which works opposite to insulin by increasing the amount of glucose in the blood. Without these alpha cells we are at risk for “brittle” diabetes and large swings in our blood sugar. Another big difference between TPAIT type 3c and other types is the malabsorption issues that we can face after surgery. Since we have large portions of our digestive systems removed, including the lower stomach and duodenum, the way our food and nutrients are digested may impact our insulin needs.

The pancreas has both endocrine and exocrine function. The endocrine function is secreting hormones, such as insulin, into the blood and the exocrine function is secreting digestive enzymes, bicarbonate, and water into the duodenum to begin the digestion of food. Most type 3c diabetics require prescription digestive enzymes when eating. Pancreatic conditions typically affect the exocrine function of the pancreas so we have to supplement these enzymes to aid with digestion. Without the proper dosage and timing when taking the capsules, we cannot properly digest food and can face serious gastrointestinal complications and malabsorption of nutrients.

When it comes to the diabetes community, there is not a large representation of people with type 3c. Type 3c is rare and often misdiagnosed. When someone is suffering from a pancreatic condition and they develop diabetes as a result, doctors often just call it type 2. I imagine this is due to a lack of information, research on type 3c, and insurance coverage.

There are a few things that I wish people knew when it comes to type 3c. The most important to me is that, when you have diabetes alone, your pancreas isn’t “dead”. The pancreas is often referred to as dead or useless in the diabetes community. Using these terms is false and misleading.

Endocrine cells make up 5% of the overall pancreas. Diabetes is an endocrine disease, and diabetes doesn’t necessarily mean you have zero pancreatic endocrine function. Many people with type 1 diabetes may have functioning alpha cells (producing glucagon) because the initial autoimmune attack is limited to the beta cells of the pancreas. Exocrine cells make up the other 95% of the pancreas, and for people with type 1 diabetes and no other pancreatic condition, this function is still working smoothly. Both endocrine and exocrine functions are vital in their own way to the body. Your pancreas could be considered “useless” if you are missing both of those functions. In any other context, it spreads misinformation.

I feel that most people with diabetes, of any type, want the general public to better understand our condition. We want them to understand the differences between the types. We want them to understand what causes or doesn’t cause diabetes. If that’s the case, why would we want to give them misinformation in the process? It’s not helping society understand diabetes. It’s not helping people with diabetes to understand diabetes. I honestly think that some people who say their pancreas is useless believe it to be true, because it’s what they’ve heard others say. And I know the diabetes community can do better to help educate within our community and also to the general public. I know the type 3c community would appreciate being recognized and validated. We haven’t had many opportunities to have our voices heard from large diabetes organizations or within the community. I know I will never stop using my voice to advocate for us. I can only hope to have the support of the diabetes community behind us.

Source: diabetesdaily.com

FreeStyle Libre 3 Cleared in Europe – Smaller, Thinner, and No More Scanning!

This content originally appeared on diaTribe. Republished with permission.

By Matthew Garza and Katie Mahoney

The FreeStyle Libre 3 has been cleared in Europe for anyone ages four and older. The new continuous glucose monitor is as small as two stacked US pennies, provides real-time readings directly to the mobile app via Bluetooth, and has the same low list price

Abbott announced that the new FreeStyle Libre 3 has been cleared in Europe – see 40-second video here. This third-generation continuous glucose monitor (CGM) has many of the same features that make the FreeStyle Libre 2 so popular, including optional alarms, 14-day wear, and high accuracy. The FreeStyle Libre 3 also adds several new features:

  • Real-time, minute-by-minute readings are sent directly to the FreeStyle Libre 3 app via Bluetooth – moving this CGM from “on-demand” to “always-on,” so there is no need to scan the sensor every eight hours.
  • It is 70% smaller than previous models, making it the “smallest and thinnest” CGM sensor yet – it’s said to be about the size of two stacked pennies. Importantly, this new model will reduce the amount of plastic and carbon paper used, improving the production of the device significantly from an environmental perspective.
  • It is cleared for people with diabetes as young as four years old.
  • It is cleared for use in gestational diabetes and pregnant women with type 1 diabetes. We suggest that everyone who is pregnant and has type 1 diabetes try to get CGM, and that everyone else who is pregnant be tested for gestational diabetes as early on as possible.
  • It is cleared as an iCGM, meaning it can be used for automated insulin delivery (AID) development in Europe.
  • The new FreeStyle Libre 3 app, available for both iOS and Android devices, will contain many of the same features as the FreeStyle Libre 2 app (Libre View) including the all-important time in range graphs and ambulatory glucose profile (AGP). You can learn all about the AGP here.

Currently the FreeStyle Libre 3 is cleared for upper-arm wear, though we imagine people may try to use it “off-label” on their abdomen or other spots. There is no separate reader for collecting and monitoring sensor data, so people will use smartphones with the FreeStyle Libre 3 app in order to connect to the sensor.

The FreeStyle Libre 3 will be available at the same price as previous versions of the CGM ($109 for a one-month’s supply, without insurance); Abbott will continue to offer the FreeStyle Libre 2 at the same price for people who prefer the to scan their CGM. The FreeStyle Libre 3 is expected to launch in the coming months in Europe, and though we don’t yet know where it will first launch, we expect it may be Germany, like Abbott’s other CGM launches. In the US, Abbott has not announced any potential timeline for FDA submission or clearance. With the recent Libre Sense clearance in Europe, there is lots happening with this brand – stay tuned for more. Readers in European countries, we’d love to hear your early thoughts once you try the FreeStyle Libre 3!

Source: diabetesdaily.com

Sous Vide Mini Keto Pumpkin Cheesecakes

This content originally appeared on Caroline’s Keto Kitchen. Republished with permission.

It’s fall, y’all! And that’s pretty much synonymous to pumpkin for me. Lolli has launched their seasonal Pumpkin Spice Cookie Clusters and given their clusters make such an amazing crust, mini cheesecakes made their way to the top of my (177 item!) to-bake list.

Historically when I’ve made cheesecake I’ve always used springform pans (or mini springform pans). While occasionally I’ll get lucky, more often than not I either have trouble getting the cheesecake out of the pan perfectly and/or the top of the cheesecake cracks while baking. I recently got a sous vide, and when I was searching for ideas of things to make with it, I saw a few articles rave about sous vide cheesecake. So I ordered 4oz mason jars from Target and decided I’d give it a go. And I’m certainly glad I did – these are what my pumpkin dreams are made of!

This recipe makes 6 mini cheesecakes, and there are only 3g net carbs per cheesecake!

pumpkin cheesecake

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Sous Vide Mini Keto Pumpkin Cheesecakes

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This pumpkin cheesecake in a mason jar might be the next recipe you'll fall for. With only 3g of net carbs per serving, it's definitely worth a try!
Course Dessert, Snack
Cuisine American
Keyword cheesecake, fall, pumpkin
Servings 6 cheesecakes
Calories 209kcal

Ingredients

  • 8 oz cream cheese softened
  • 1 large egg
  • 1 tsp vanilla
  • 1/2 cup powdered Swerve
  • 1/4 cup canned pumpkin
  • 1/2 tsp pumpkin pie spice
  • 1/2 tsp baking powder
  • 1/2 tsp monk fruit juice concentrate
  • 1 cup Lolli's Pumpkin Spice Cookie Clusters

Instructions

  • Mix together the softened cream cheese, egg, vanilla, powdered Swerve, pumpkin, pumpkin pie spice, baking powder and monk fruit juice concentrate. (If your cream cheese is clumping, use an immersion blender to get it super smooth).
  • Fill your sous vide container with water up to the minimum line, clip on your sous vide, and pre-heat to 80 degrees Celsius/176 degrees F.
  • Use a Ninja/Magic bullet to pulse the Pumpkin Spice Cookie Clusters to crumbs.
  • Divide the Cookie Cluster crumbs evenly among six 4-oz mason jars. Press crumbs down using a spoon to make a compact crust.
  • Divide the cheesecake batter evenly among the mason jars on top of each crust.
  • Secure the lids. It’s important they’re tight enough that water does not get in, but don’t screw them on too tight or they could explode in the sous vide (or at least that’s what I read – thankfully I have no firsthand knowledge here).
  • Use tongs to place the mason jars in the sous vide container. Make sure they’re all right side up and side-by-side (versus on top of one another).
  • Keep in the sous vide for two hours. Remove with tongs and set on a wire cooling rack with a kitchen towel beneath to collect any water.
  • Allow mason jars to cool fully to room temperature, and then place in fridge.
  • Keep in fridge for at least two hours – though ideally overnight – before eating.

Notes

Net carbs per cheesecake: 3g

Nutrition

Calories: 209kcal | Carbohydrates: 4g | Protein: 4g | Fat: 20g | Saturated Fat: 8g | Polyunsaturated Fat: 1g | Monounsaturated Fat: 4g | Cholesterol: 69mg | Sodium: 131mg | Potassium: 61mg | Fiber: 1g | Sugar: 2g


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Sous Vide Mini Keto Pumpkin Cheesecakes Recipe

Source: diabetesdaily.com

Mark Andrews: A Tight End with Type 1 Diabetes

This content originally appeared on Beyond Type 1. Republished with permission.

By Katie Doyle

The Baltimore Ravens didn’t choose just any offensive lineup during the 2018 NFL draft – a key part of their strategy is Mark Andrews, a tight end from the University of Oklahoma who has been managing his type 1 diabetes since before he started playing football and into his rookie season.

Beyond Type 1 spoke with Mark about his pre-game rituals, how technology like the Dexcom G6 helps him stay on top of type 1 on long Sunday afternoons, and why it’s important to use his high-profile career to educate and advocate with National Diabetes Awareness month coming up.

How have you managed your diabetes through major life changes, like going away to college, playing a division 1 sport, or going through the NFL draft?

I was diagnosed at 9 years old, and it was the first time I ever saw my dad cry. At that moment, I knew it was serious because it wasn’t something my dad did very often. And since then, my family has been my rock. I was lucky enough to have a dad who was also a doctor and had an understanding of diabetes when I first was diagnosed.

Personally, I wasn’t very nervous. I knew that one day I wanted to move out, play football at a Division 1 level and ultimately play in the NFL. It’s something I was always very diligent about. I wasn’t going to let my nerves or anything else get in the way of that. My mom probably worried most, but my dad was instrumental in instructing my whole family in what to expect and what to know. I rely on them a ton. Using a CGM allows them to be a part of it and know my numbers at all times. It gives them peace of mind to be able to check in on me.

Mark

Image source: Beyond Type 1

How does your family support you from across the country?

My mom will always be my mom, so she still checks on me regularly. Last week, she texted me and said, ‘Hey, I don’t think you have enough complex carbs on board, you’ve been going low and trending low a lot. Just want you to eat something that gives you more complex carbs. I love you, hope you’re having a good week; I’ll talk to you soon!”

It’s awesome to get a text message like that and know my family has my back. After that, I ate a peanut butter and jelly sandwich just to have that background complex carb and went about my day. It’s always good having people look out for you — the more eyes you have on someone with diabetes, the better.

I’ve got a teammate right now named Orlando Brown whose dad had diabetes so he’s incredibly well-informed. He was my college teammate and now he’s my NFL teammate with the Ravens. He’s always wondering what my numbers are, and I actually share my numbers with him from my Dexcom.

When did you feel comfortable enough to talk to your friends and teammates about diabetes?

At first, I remember feeling a little bit reserved and not being totally open about it. I’d go hide in a corner to test. I also remember the first time my friends saw me testing my blood sugar. I was 10 or 11 years old, and they saw blood and thought it was cool. I was kind of in the spotlight because they were so interested in what I was doing.

That opened me up to be more vocal and to share what I’m doing and how I deal with things. After that, I became really comfortable sharing what I deal with having T1D and how I deal with it and sharing with others. I was very open talking to my coaches, and I had my parents to help me out with that, and they still do that to this day. Ever since then, I’ve always wanted to talk about it and shed light on what people with diabetes have to do.

Tell us about your pre-game ritual.

I do something a little bit different: I wear a pump, so I use that for basal (25%) and I use Lantus for my other type of basal (75%) on a normal day. But on a game day, I’ll go 100% Lantus — that allows me to be off the pump for long periods of time but not have to worry.

Knowing your body is key. Knowing what I put in my body and how it will affect me is something that I feel has been instrumental for my health. I’m a big fan of complex carbs; I eat peanut butter and jellies, especially on game days or the day before a game, just allowing myself to have that complex carb to hold me over while I’m exerting a lot of energy.

Having my Dexcom, and the way it allows me to see my blood glucose trends and see what foods react a certain way has been huge for me. There’s a lot that goes into diabetes management, and I think it’s incredible that I can rely on Dexcom and not have to prick my fingers all the time. It really sets me up for success on the field.

Who are your role models?

I didn’t know anyone else with diabetes growing up, but I have my dad, who is extremely knowledgeable and always researching different things. He’s the reason I went to 100% Lantus for game days.

I can remember, at a young age, having diabetes and seeing Jay Cutler in the League, and being able to tell myself that it’s possible. I adopted a mindset that this disease is a part of who I am, but it’s not going to define me and it’s never going to stop me in achieving my dreams. Football is my passion, it’s what I love, but now it’s my job, and diabetes is something I refuse to let affect my job.

You seem like you have a ritual down for games, but how about during the NFL draft? How were you feeling then?

There’s so much work that had been put into that moment, from my mom driving me to soccer practice, to all those hard hours put in on the field, it all lead to that moment of actually playing in the NFL. It was kind of scary to know that that you’re putting your future into someone else’s hands — into 32 organizations’ hands — but this has been my dream for a very, very long time.

Why is it important for young athletes with type 1 to have role models?

To be put on this stage, I’ve always wanted to give back and for me, that’s with diabetes — that hits home for me. Helping kids with diabetes is something that I’ve found has given me the most reward: raising awareness and talking to people about how I use technology and what I do with it, it’s to help people with everyday life and share some of that.

I’m going to work as hard as I can to be the best tight end that I can be, and hopefully one of the premiers tight ends in the League. I want kids to see where I’m at today, like I saw Jay Cutler, and I hope it inspires them to go out there and play sports and be active — to follow their dreams, no matter what they may be. A professional football player? Great! Go out and achieve it. Or if anything else, you know, This guy’s playing football at the highest level, then I can do anything else!

Source: diabetesdaily.com

What Are SGLT-2 Inhibitors and How Can They Help Your Heart?

This content originally appeared on diaTribe. Republished with permission.

By Mary Barna Bridgeman

SGLT-2 inhibitors can protect your heart! This type of medicine is recommended for people with type 2 diabetes who have heart disease or risk factors related to heart disease. Learn about the use of these medicines, including side effects, their effect on A1C, and their role in supporting heart health

Diabetes is a risk factor for heart disease: people with diabetes are twice as likely to have heart disease or a stroke compared to those without diabetes. Heart disease is often a “silent” condition, meaning that symptoms are not necessarily present until a heart attack or a stroke actually happens. It is important for people with diabetes to realize they may be at risk – click to read more about the link between diabetes and heart disease from Know Diabetes By Heart.

There are many ways to take care of your heart and to reduce the risk of heart disease while living with diabetes. New medicines, including sodium-glucose cotransport 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) agonists, have been shown to protect the heart and reduce the risk of many specific heart-related outcomes. This article will focus on SGLT-2 medications, and our next article will focus on GLP-1 medications.

Heart diseases

Image source: diaTribe

Click to view and download diaTribe’s helpful infographic on preventing heart disease.

What are SGLT-2 inhibitors?

There are currently four medicines that are categorized as SGLT-2 inhibitors:

These medicines help people with type 2 diabetes manage their glucose levels: they work in the kidneys to lower sugar levels by increasing the amount of sugar that is passed in the urine. SGLT-2s increase time in range and reduce A1C levels while also lowering blood pressure and supporting weight loss. For people with diabetes who have had a heart attack or are at high risk of heart disease, or who have kidney disease or heart failure, these medicines could be considered regardless of A1C level. While SGLT-2 medications are expensive, some assistance programs are available to help with cost – see one of diaTribe’s most popular articles, “How to Get Diabetes Drugs For Free.”

What do you need to know about SGLT-2 inhibitors?

SGLT-2s have a low risk of causing hypoglycemia (low blood sugar levels). Because they increase sugar in the urine, side effects can include urinary tract infections and genital yeast infections in men and women. Dehydration (loss of fluid) and low blood pressure can also occur. Symptoms of dehydration or low blood pressure may include feeling faint, lightheaded, dizzy, or weak, especially upon standing.

Before starting an SGLT-2 inhibitor, here are some things to discuss with your healthcare team if you have type 2 diabetes:

  • How much water to drink each day
  • Ways to prevent dehydration and what to do if you cannot eat or you experience vomiting or diarrhea (these are conditions that may increase your risk of developing dehydration)
  • Any medicines you take to treat high blood pressure

When prescribed for people with type 2 diabetes, SGLT-2s rarely cause diabetic ketoacidosis (DKA), a serious and potentially life-threatening condition. For people with type 1 diabetes, DKA is a well-known risk when SGLT-2s are prescribed. Call your healthcare professional if you have warning signs of DKA: high levels of ketones in your blood or urine, nausea, vomiting, lack of appetite, abdominal pain, difficulty breathing, confusion, unusual fatigue, or sleepiness. When you are sick, vomiting, have diarrhea, or cannot drink enough fluids, you should follow a sick day plan – see Dr. Fran Kaufman’s article on developing your sick day management plan. Your healthcare professional may instruct you to test your urine or blood ketones and stop taking your medication until symptoms go away.

If you have type 1 diabetes or chronic kidney disease, depending on your level of kidney function, these medicines may not be for you. Additionally, SGLT-2s are associated with increased risk of lower limb amputation.

SGLT-2 inhibitors are usually taken as a pill once a day – often in the morning before breakfast – and can be taken with or without food.

What do SGLT-2 inhibitors have to do with heart health?

Results from clinical studies suggest SGLT-2 inhibitors may play an important role in lowering heart disease risks.

Jardiance was the first SGLT-2 inhibitor to show positive effects on heart health in the EMPA-REG OUTCOME trial. In this study, more than 7,020 adults with type 2 diabetes and a history of heart disease were followed. Participants received standard treatment for reducing heart disease risk – including statin medications, blood pressure-lowering drugs, aspirin, and other medicines – and diabetes care, plus treatment with Jardiance. Over a four-year period, results from the study showed that, compared to placebo (a “nothing” pill), Jardiance led to:

  • a 14% reduction in total cardiovascular events (heart attacks, strokes, heart-related deaths)
  • a 38% reduction in risk of heart-related death
  • a 32% reduction in overall death
  • a 35% reduction in hospitalizations from heart failure

Read diaTribe’s article on the results here.

Similarly, the heart protective effects of Invokana have been shown in two clinical studies, CANVAS and CANVAS-R. These two studies enrolled more than 10,140 adults with type 2 diabetes and a high risk of heart disease, randomly assigned to receive either Invokana or placebo treatment. In the CANVAS studies, treatment with Invokana led to the following:

  • a 14% reduction in total cardiovascular events (heart attacks, strokes, heart-related deaths)
  • a 13% reduction in risk of heart-related death
  • a 13% reduction in overall death
  • a 33% reduction in hospitalizations from heart failure

Read diaTribe’s article on the results here.

Farxiga may also reduce heart disease risks. In the DECLARE-TIMI 58 study, more than 17,000 people with type 2 diabetes received Farxiga; 40% of participants had known heart disease and 60% had risk factors for heart disease. Importantly, more than half of the people included in this study did not have existing heart disease. While Farxiga was not found to significantly reduce total cardiovascular events (heart attacks, strokes, heart-related deaths) compared with placebo, its use did lead to a 17% lower rate of heart-related death or hospitalization for heart failure. Read diaTribe’s article about the results here.

More recently, the DAPA-HF study evaluated the use of Farxiga for treating heart failure or death from heart disease in people with or without type 2 diabetes. The study included more than 4,700 people with heart failure; about 42% of those enrolled had type 2 diabetes. Farxiga was shown to reduce heart-related death or worsening heart failure by 26% compared to placebo, both in people with type 2 diabetes or without diabetes. Learn more about these results here.

All of the available SGLT-2 inhibitors have evidence suggesting benefits of this class of medications for people with established heart failure. Click to read diaTribe’s article on SGLT-2 Steglatro and heart health.

Other possible benefits of SGLT-2 inhibitors

InvokanaFarxiga, and Jardiance have also been shown to reduce the progression of kidney disease. Learn more about diabetes and kidney disease here.

SGLT-2s have been studied in people with type 1 diabetes, but are not yet approved for use by the FDA – you can learn about SGLT-2s for people with type 1 diabetes here.

What’s the bottom line?

You can reduce your risk of heart disease and promote heart health while living with diabetes. You and your healthcare team should develop a personalized plan to determine what ways are best for reducing your risk of heart disease. According to the latest evidence and treatment recommendations, SGLT-2 inhibitors may be most useful for people with type 2 diabetes and heart disease or at high risk of heart disease.

About Mary

Mary Barna Bridgeman, PharmD, BCPS, BCGP is a Clinical Professor at the Ernest Mario School of Pharmacy at Rutgers University. She practices as an Internal Medicine Clinical Pharmacist at Robert Wood Johnson University Hospital in New Brunswick, New Jersey.

This article is part of a series to help people with diabetes learn how to support heart health, made possible in part by the American Heart Association and American Diabetes Association’s Know Diabetes by Heart initiative.

Source: diabetesdaily.com

Protein-Packed Keto Chili in the Crock or Instant Pot

This content originally appeared here. Republished with permission.

By Suzanne Ryan

This recipe includes two things that I’m a big fan of, easy crock-pot (and Instant Pot) meals and chili! I love being able to quickly toss some fresh ingredients into the slow cooker in the morning, and have a nice and easy dinner in the evening. This keto chili recipe is on a weekly rotation in our house, and I hope you enjoy it as much as we do!

It’s simple to make this chili and will only take 15 minutes to prep. Start by browning the ground beef and sausage in large pan. Use a wooden spoon to break up the clumps. Drain the meat, and reserve half of the drippings.

Transfer the drained meat into the slow cooker and add the other ingredients. Stir to combine. Cook 6-8 hours on low – you’ll know it’s ready when the veggies are soft.

Top with your favorite chili toppings like shredded cheese, green onions, sour cream, and/or sliced jalapenos. Yum!

Also, if you have an instant pot, you can make this chili in as little as 40 minutes – instructions are listed below!

keto chili

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Keto Chili

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Each cup of tasty chili contains a whopping 33.5g of protein and just 7.9g of carbs.
Course Main Course
Cuisine American
Keyword Chili
Prep Time 15 minutes
Cook Time 8 hours
Total Time 8 hours 15 minutes
Servings 6 people
Calories 387kcal

Equipment

  • Slow Cooker

Ingredients

  • 1 lb. ground beef
  • 1 lb. ground sausage regular or hot depending on preference
  • 1 medium green bell pepper chopped
  • 1/2 medium yellow onion chopped
  • 1 can diced tomatoes in tomato juice 14.5 oz
  • 1 can tomato paste 6oz
  • 1 tbsp. chili powder may need to use more if you choose a mild sausage
  • 1/2 tbsp. ground cumin
  • 3-4 pcs garlic gloves minced, or 1 tbsp garlic powder, which is .8 net carb additional per serving
  • 1/3 cup water

Instructions

  • In a large pot, brown the ground beef and sausage using a wooden spoon to break up the clumps. Drain the meat, reserving half of the drippings.
  • Transfer the drained meat into a slow cooker. Add the reserved drippings, bell pepper, onion, garlic, tomatoes with juice, tomato paste, chili powder, cumin and water and mix well.
  • Place the lid on the crockpot, set on low, and cook for 6-8 hours, or high for 5 hours, until veggies are soft.
  • Serve topped with shredded cheese, green onions, sour cream, and/or sliced jalapenos.

Notes

  • Macros will vary depending on the brands that you purchase, so be sure to look for the lowest carb options with the tomato paste, diced tomatoes in tomato sauce, and sausage.
  • Net carbs: 7.9g

Nutrition

Serving: 1cup | Calories: 387kcal | Carbohydrates: 11.4g | Protein: 33.5g | Fat: 24g | Fiber: 3.5g


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

 

Keto Chili Instant Pot Cooking Instructions: Ready in 40 Mins!

Prep time: 5 mins / Cook Time: 35 Mins / Total: 40 Mins

  1. Press the “Sauté” button on the Instant Pot, and add the ground beef and sausage to the pot and cook until brown.
  2. Once meat is browned set Instant Pot to “keep warm/cancel”.
  3. Add the remaining ingredients into the Instant Pot and mix well. (No need to remove liquids as instructed in crock pot cooking method), then cover and lock the lid. Make sure the steam valve is closed.
  4. Select Bean/Chili setting (30 mins).
  5. Once the chili is done, the Instant Pot will automatically switch to the “Keep Warm” mode. Allow the pressure to release naturally or use the quick release.
  6. Stir chili before serving!

JENNIFER SKOG

About the Author

Suzanne Ryan (@ketokarma) discovered the ketogenic diet in January 2015, and it completely changed her life. When she started keto, Suzanne weighed 289 pounds, and her energy level and self-esteem were at an all-time low. She felt tired, sick, and frustrated by her inability to stick to a healthy diet. After just one year, she had lost 100 pounds and developed a new mind-set surrounding food. Suzanne is currently down 120 pounds, and she’s passionate about helping others find the same success. Check out her other recipes at Keto Karma.

Keto Chili – Crock Pot or Instant Pot Recipe

Source: diabetesdaily.com

COVID-19: What Your Friends with Pre-Existing Conditions Need You to Know

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

The first few months of 2020 presented a global health crisis not seen in almost a century. When the coronavirus first emerged, wild theories abounded. We didn’t know who was most at risk to get severely ill or die. There was a mind-numbing amount of conflicting information – do we wear masks or not? Is this virus airborne or does it live on surfaces? Am I safe to go outside at all?

For those of us living with chronic diseases like diabetes, this was all exponentially more intense. Living with an invisible illness during a pandemic is a uniquely anxiety-inducing and isolating experience. Each of us has our own level of fear about our risk, but much of our ability to protect ourselves was based on pure gut feelings because no one had enough data from which to make informed decisions.

Now, we know a little bit more. Living with diabetes itself does not appear to increase our risk of contracting coronavirus, but if we do get COVID-19 and end up in the hospital, things could go south quickly. It also seems like many people who do end up in the hospital have other underlying heart or lung conditions or are older in age, so we don’t know what percentage of risk is diabetes-specific. For many of us, memories of poor diabetes care in hospital settings is a major risk to consider – COVID-19 may not kill us but a medical professional who doesn’t listen to or know how to take care of our needs might. And it may not even be their fault – in an overly taxed medical system that does not have the resources to take care of the volume of people who are sick right now, people with often-misunderstood chronic illnesses fall to the wayside.

Existing in the world with a disease like diabetes can already be already dangerous. Existing in a world currently going through a pandemic, with conflicting and limited guidance and leadership, broken healthcare systems, a taxed medical supply chain, and the medication that is our lifeline often too expensive to afford? It’s all still scary, and while we know a little bit more, we’re still flying blind and doing the best we can amidst constantly changing circumstances. Here’s some of what your friends with pre-existing conditions want you to know:

  1. This is still really scary; please give me space and time to figure out what decisions are best for me. Every person living with a pre-existing condition is different. Many of us live with multiple health hurdles we’re juggling, and even within the same disease, we each have to take care of ourselves in different ways. Some of us feel completely safe starting to return to (socially-distanced, while wearing a mask) everyday activities, while some of us feel safer continuing to stay at home. Some of us don’t have a choice — the need to earn a paycheck to support ourselves, our families, or keep our health insurance supersedes our fears. Be kind. Be patient. Don’t assume to know what we need. Ask us how you can support us.
  2. Please stop sending me articles about people with my disease dying from COVID-19. I’ve either already seen it or I’m purposely ignoring it for mental health reasons. I promise I already know all of the risks someone like me faces, and I am doing everything I can to mitigate them. It is my job to pay attention to the level my health requires, and I promise I’ve already done it.
  3. I reserve the right to change my mind at any time for any reason. In a time when we are all making decisions on the fly, there are days we’re agreeing to things because the most recent headline we saw seemed positive, or we’re having a strong mental health day. At any moment, for any reason, that may change. New studies about how COVID-19 affects people are published weekly, with studies that then directly conflict following just a week later. We’re not being flaky; we’re trying to keep ourselves alive in a constantly changing landscape.
  4. “Don’t worry, it only kills people who are old or already sick” is still a really horrible thing to hear. Knowing that there are so many people in the world who care so little about our lives is heavy. For many of us, this is simultaneously compounded by how society views our race, our culture, our social standing, our access to healthcare or a paycheck. We are being told we do not matter from multiple directions, and we are exhausted.
  5. Having a discussion about a COVID-19 vaccine isn’t productive for me. While there are many companies doing clinical trials, there is no current frontrunner. Once there is, there will be conversations about priority vaccinations. No, I don’t know if I will be able to get one. Don’t ask me about how I feel about vaccinations and what I will do once I get one or if I should get one. There are still many unanswered questions about what will happen after a vaccine becomes available and I’m just trying to stay safe until then.
  6. I still love you. But if I say I can’t visit with you yet, please respect that. I miss you immensely. I wish I could see you. Right now, I’m having to weigh the very real thought that if we visit together right now, there’s a chance I won’t be around to know you for the rest of your life. I don’t want to have to make that decision. Please don’t ask me to.
  7. Please stay home while waiting for your COVID-19 test results or if you’re feeling under the weather. This may not feel like a big deal to you. You may not feel like COVID-19 will impact you too harshly or you probably won’t end up interacting with anyone who is high risk when you go outside. But there’s no way to know who’s path you’ll cross and what impact COVID-19 could have on them or someone they are going home to. Many of us who are at higher risk do not have the option of staying inside and away from you. We have to get groceries for our families, we have to earn a paycheck, we have to see our doctor, and many of us don’t look sick. You won’t know when you cross paths with a high-risk person. Please don’t make those choices potentially deadly for us.

To learn more about the precautions everyone impacted by diabetes should take throughout the COVID-19 pandemic, visit coronavirusdiabetes.org.

Source: diabetesdaily.com

Semglee, A Low-Cost Basal Insulin, Comes to the US

This content originally appeared on diaTribe. Republished with permission.

By Karena Yan and Joseph Bell

A more affordable alternative to Lantus (insulin glargine) will cost $148 for five pre-filled insulin pens

Mylan and Biocon Biologics announced last month the long-awaited US launch of Semglee, a new insulin aiming to be deemed “biosimilar” to insulin glargine (basal insulin) by the FDA. A biosimilar drug is a biological product that is highly similar in structure and function to a product already approved by the FDA, known as the reference product. Semglee is said to be similar to Sanofi’s basal insulin Lantus; it has the same protein sequence and has a similar glucose-lowering effect. The FDA has yet to classify Semglee as “biosimilar” or “interchangeable” to Lantus due to the need for additional review – so for now, Semglee should be considered a new basal insulin option for people with diabetes. Semglee was previously approved in 45 countries, including Australia, Europe, Japan, and South Korea. We aren’t positive how “interchangeable” will go – would someone using Tresiba or Toujeo “next-generation basal” insulin want to go with Semglee instead? This is unlikely in our view.

Semglee is currently available by prescription in either a pen or a vial and can be used by people with type 1 or type 2 diabetes. It costs $147.98 for five 3 mL pre-filled pens or $98.65 for one 10 mL vial. Semglee is reported to be the cheapest available insulin glargine-equivalent on the market, with a 65% discount from the list price of Lantus. That calculation is a bit misleading as does not take into account discounts and rebates available with a variety of insulin brands; actual out-of-pocket costs can differ dramatically for individuals.

Happily for people who don’t qualify for patient assistance programs, Semglee represents a far more affordable option for people with type 1 and type 2 diabetes who take basal insulin. While biosimilars are usually not as inexpensive as “generic” versions of drugs, because biosimilars are more expensive to manufacture, they do provide cheaper alternatives to brand name drugs, in this case, Lantus (and Levemir, Tresiba, and Toujeo). Further, because Semglee is thought to be essentially equivalent to Lantus, it should provide an important and practical option for basal insulin users who are concerned about insulin costs and do not have a route to pay less – this is far more people than often considered.

It’s also key to note that Semglee is not technically considered a “biosimilar” drug – it is currently under FDA review to gain approval of this designation. The biosimilar designation would mean that Semglee officially has bioactivity and clinical efficacy that are not different from Lantus, but are not necessarily exactly the same. If it earns an “interchangeability” designation, pharmacists would be able to substitute Semglee for Lantus without consulting the prescribing healthcare professional. Semglee might also be substituted for Tresiba or Toujeo, two “next generation” more stable basal insulins.

Two biosimilar insulins are currently approved in the US: Basaglar, a basal insulin glargine approved in 2016, and Admelog, a rapid-acting insulin lispro approved in 2018. If Semglee gains an FDA biosimilar designation, it will become the third biosimilar insulin available in the US.

Mylan is offering a co-pay discount card and a patient assistance program to help people afford Semglee. The co-pay card is available to people with commercial health insurance – you may be able to receive up to $75 off each 30-day prescription. Learn more here. For people without prescription insurance coverage, you may be able to get Semglee for free – access the patient assistance program by calling Mylan customer service at (800)796-9526.

Source: diabetesdaily.com

Low-Carb Caramel Apple Cheesecake Bars

This content originally appeared on Sugar-Free Mom. Republished with permission.

It may seem like a bit of work, but it’s a pretty simple recipe with 3 easy layers of deliciousness!

The first layer is like a shortbread crust made without almond or other nuts for those who have tree nut allergies like my youngest son. The middle is all cheesecake filling and it’s topped with a crumble of apples and coconut flour mixture to make it have some fabulous texture once baked!

Of course it’s best if chilled, but you could certainly enjoy it straight from the oven. Just be sure to allow it some time to set or it will fall apart when you try cutting into it. Cheesecake and crusts without gluten are known for that, just part of the issue baking low-carb. Wait a bit and this will slice easily. Enjoy it with some of my Sugar-Free Caramel Sauce on top!

Low-Carb Apple Cheesecake Bar

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Keto Low-Carb Caramel Apple Cheesecake Bars

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Your bite of fall: Shortbread crust filled with creamy cheesecake and topped with a crumble of apples.
Course Dessert
Cuisine American
Keyword apple, cheesecake
Prep Time 30 minutes
Cook Time 30 minutes
Total Time 1 hour
Servings 16 bars
Calories 229kcal

Ingredients

Shortbread Crust

  • 1/2 cup butter softened
  • 1 cup coconut flour
  • 1/2 tsp cinnamon
  • 1/4 tsp salt
  • 1 tsp Caramel Liquid Stevia or 1/2 cup sweetener of choice

Cheesecake filling

  • 16 ounces cream cheese room temp
  • 1/2 cup sour cream
  • 1/3 cup heavy cream
  • 1 tsp apple extract
  • 1/2 tsp salt
  • 1 tsp Caramel Liquid Stevia

Topping

  • 3/4 cup apples skinless, diced
  • 1 tbsp coconut flour
  • 1/2 tsp apple pie spice
  • 1/4 tsp salt
  • 2 tbsp butter softened
  • 1/2 tsp Caramel liquid stevia

Instructions

  • Preheat oven to 350 degrees F. Combine crust ingredients together in a bowl and stir well until combined. Spread onto a parchment-lined, 8-by-8-inch baking dish.
  • Combine all cheesecake ingredients in a stand mixer, or use an electric mixer on medium speed, until smooth and well incorporated. Taste and adjust stevia if needed. Spread the cheesecake filling over the crust evenly.
  • Mix the topping ingredients together in a small bowl, then sprinkle mixture over the cheesecake. Bake for 30 minutes, then chill 3-4 hours to set or overnight. Top with sugar-free caramel sauce, if desired.

Notes

Recipe Notes

  • Net carbs: 4g

Brenda’s Notes: 

 

Nutrition

Calories: 229kcal | Carbohydrates: 7g | Protein: 3g | Fat: 21g | Saturated Fat: 13g | Cholesterol: 61mg | Sodium: 324mg | Potassium: 59mg | Fiber: 3g | Sugar: 2g | Vitamin A: 723IU | Vitamin C: 1mg | Calcium: 41mg | Iron: 1mg


Please note that the nutritional information may vary depending
on the specific brands of products used. We encourage everyone to check specific
product labels in calculating the exact nutritional information.

Low-Carb Caramel Apple Cheesecake Bars Recipe

Source: diabetesdaily.com

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